Bile Duct

What is the bile duct?

The bile duct is a duct that carries bile from the liver to the intestine.

What does the bile duct do?

The bile ducts act as the drainage system of the liver.

Bile Duct Cancer

Cholangiocarcinoma is a primary cancer of the bile ducts. These cancers are often hard to detect until the patient becomes jaundice (yellow). Cholangiocarcinoma is a cancer associated with certain immunologic disorders including ulcerative colitis and primary sclerosing cholangitis. Patients with these related disorders should be monitored by their gastoenterologists. Detection of early cancers is only done through endoscopic retrograde pancreatography (ERCP). During this procedure the gastroenterologist passes a catheter through the bile duct from the first portion of the intestine (duodenum). Then, scrapings of the bile duct can be examined for cancer cells or a new micro camera can be passed through the bile duct to visualize the presence of a tumor.

Diagnostic Procedures

There are various ways of screening for pancreatic cancer, available at Jewish Hospital & St. Mary’s HealthCare facilities.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Offered at the following locations:

• Jewish Hospital
  (502) 587-4327
• Jewish Hospital Medical Center East
  (502) 587-4431
• Sts. Mary & Elizabeth Hospital
  (502) 361-6161

Endoscopic Ultrasound (EUS)

Offered at the following location:

• Jewish Hospital
  (502) 587-4327

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Spyglass

Offered at the following location:

• Jewish Hospital
  (502) 587-4327

Treatment

The only cure for this cancer is surgical resection.

Operative Therapy

Operative therapy is based on the size and location of the tumor. If the tumor is discovered in the lower bile duct, resection of the pancreatic head is indicated (whipple procedure). If the tumor is located in the middle or upper duct, the bile duct and a portion of the liver is most commonly removed. Three programs have an active interest in transplantation for this malignancy. Unfortunately, these patients have tumors discovered incidentally and have extremely limited extent. Less than five percent of patients are accepted into these protocols. If they are, they proceed on to local radiation and systemic chemotherapy prior to transplantation.

Our Experienced Team

The team at the Jewish Hospital Transplant Center has an extensive experience with the resection of high cholangiocarcinomas in the area of the bile duct bifurcation (Klatskin tumors). We have resected over 80 of these rare tumors with a variety of aggressive techniques, including major vascular resections and reconstructions.

Bile Duct Injuries

Bile duct injuries are an uncommon but often a devastating complication of an elective removal of the gallbladder. The bile can be clipped and divided or a hole created in the side of it. The most lethal injury to the bile duct involves the injury to either the right hepatic artery or the main hepatic artery.

Treatment

Repair of these injuries involve percutaneous drainage of a bile leak. The bile duct injury is then stented though an endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). Once the duct is stented, a piece of intestine is brought together with the bile duct to repair it. With larger injuries the lobe of the liver may have to be removed.

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